Objective: To study the effects of starting antiretroviral treatment (ART) prior the age of two years on the growth (height and weight) of HIV-infected children. Methodology: This was a retrospective cohort study. HIV...Objective: To study the effects of starting antiretroviral treatment (ART) prior the age of two years on the growth (height and weight) of HIV-infected children. Methodology: This was a retrospective cohort study. HIV-infected children on ART aged less than 15 years were divided into two groups Group 1 (G1) comprising children who started ART prior 2 years and Group (G2) those put on treatment thereafter. Main Measures: Percentage of children with growth retardation measured by Height for Age (H/A) and Weight for Age (W/A) Results: In total, we included 90 subjects. The median age was 10 years with a slight female predominance (51.2%). Most children were asymptomatic at the time of the study (96.6%), compliant with treatment (81%), 54.8% of children were on cotrimoxazole, 33% knew their status. At initiation, underweight was predominant in group 1 compared to group 2 (52% versus 29.5%;p = 0.015). Conversely, stunted growth predominated in G2 compared to G1 but without significant difference (38% versus 50%;p = 0.147). At the time of our study (median age of 10 years), catch-up height and weight predominated in G1 compared to G2;only a small proportion remained below −2SD (4% versus 18.2%;p = 0.015 and 9% versus 29.5%;p = 0.006 respectively for underweight and stunted growth). Conclusion and Global Health Implications: Growth retardation was common at ART initiation. Catch-up in height was more evident in the early treatment group. Initiation of ART before the age of 2 years rather influences children’s height than weight. The result of this study further emphasizes the need of early ART and closed clinical monitoring to better assess the impact of ART in areas with high rates of undernutrition.展开更多
Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HI...Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HIV-infected patients aged 5-18 years receiving antiretroviral treatment with CD4 T-lymphocytes>25%or>500 cells/mm3 for at least 6 months.QuantiF ERON-TB Gold,T-SPOT.TB,and tuberculin skin test were performed in each patient.Results:A total of 50 patients were enrolled with median age of 13.7 years,CD4 counts of 753(IQR:587-989)cells/mm3.Among 27 patients with tuberculosis(16)or tuberculosis exposure(11),8(29.6%)were positive to at least one test,2(7.4%)were positive QuantiFERON-TB Gold,3(11.1%)positive T-SPOT.TB,and 7(25.9%)had tuberculin skin test≥5 mm.Among 23 patients without history of tuberculosis or exposure,all had negative interferon gamma release assays,while 2(8.7%)had positive tuberculin skin test.Conclusions:All tests had low sensitivity despite immune reconstitution.展开更多
Objectives: Antiretroviral therapy (ART) has been associated with lipodystrophy in children. We evaluated changes in various anthropometric measurements for the assessment of lipodystrophy and assessed whether there w...Objectives: Antiretroviral therapy (ART) has been associated with lipodystrophy in children. We evaluated changes in various anthropometric measurements for the assessment of lipodystrophy and assessed whether there was an association with use of protease inhibitors (PI), non-PI containing ART and/or stavudine (d4T). Methods: Eighty-five HIV-infected children attending the HIV clinic at Great Ormond Street Hospital (GOSH) were included. The average follow-up was 8.4 months (range 3 - 12 months). Body fat redistribution was assessed by anthropometric measurements including skinfold thickness and circumferences of upper and lower limbs. Measurements were converted to age- and sex-adjusted z-scores through development stages including puberty. Results: Sixty children had taken ART;37 received PI-containing;38 received d4T;25 had never been treated. In the studied population, clinically important changes with decreases in biceps (BSF), subscapular skinfolds and total body fat (4SFT) over period of 12 months were observed. Some increase was noticed in triceps skinfolds (TSF). Limbs circumferences remained at the same level. Further we looked at 4 months basis changes in anthropometric measurements stratified by baseline ART. Generally z-scores of anthropometric measurements were lower in therapy naive children when compared to ART groups. PI-based ART regimens resulted in significant increases in BSF with a trend towards increases in TSF, suprailiac and 4SFT. Mid-arm and thigh circumferences were higher in PI compared to naive group. Similarly, significant changes in BSF z-scores were associated with d4T use. Increases were seen in TSF and mid-arm circumference and decreases were observed in subscapular skinfolds and calf circumference z-scores. Conclusions: Body fat redistribution in HIV-infected children with sub-clinical lipodystrophy could be detected by anthropometric measurements, particularly when PI or d4T is included in ART. Over time, changes with increase in arm and trunk fat, and no change or decrease in leg fat were more pronounced among ART-receiving children.展开更多
Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with H...Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.展开更多
Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngea...Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngeal colonization is a risk factor for pneumococcal disease, a leading cause of complications and death in infants. HIV-infected persons are at high risk of invasive pneumococcal disease. Method: Nasopharyngeal swabs were collected from 296 HIV infected children below five years recruited from Gertrude’s Children hospital and Nazareth Hospital Nairobi, Kenya. The nasopharyngeal swabs were processed to isolate S. pneumoniae, which were serotyped and tested for drug susceptibility. Results: The carriage prevalence of S. pneumoniae in the study was 30.4% while the isolated serotypes were (in order of decreasing frequency): 35B, 19F, 3, 13, 15A, 11A, 16F, 7C and 23A. Most of the serotypes were resistant to the commonly used antibiotics but all were susceptible to vancomycin and chloramphenicol. Conclusion: Carriage prevalence of nasopharyngeal S. pneumonia in HIV infected children was lower than that of similar prevalence studies in children. Most of the S. pneumoniae isolates were however non pneumococcal vaccine isolates.展开更多
Objective: Studies available on cognitive function among school-aged HIV-infected African and in particular Nigerian children are few. The purpose of the study was to assess the neurocognitive function of a group of H...Objective: Studies available on cognitive function among school-aged HIV-infected African and in particular Nigerian children are few. The purpose of the study was to assess the neurocognitive function of a group of HIV-infected schoolaged (6 - 15 years) children using the Raven’s Standard Progressive Matrices (RPM). Method: Cognitive assessments of 69 HIV positive children and 69 age- and sex-matched apparently healthy HIV negative control children were performed using the Raven’s Standard Progressive Matrices (RPM). The children were subdivided (Piaget’s developmental staging) into two sub-groups: the concrete operation stage (6 - 11 years) and the formal operation stage (12 - 15 years) for analysis. Result: The mean RPM score for the HIV positive children was 18.2 (8.0 - 47.0, SD 9.8) which was significantly lower than the score of 27.2 (8.0 - 52.0, SD 13.8) for the HIV negative children (p < 0.001). On the RPM grading and using the HIV negative children as the standard, 56.5% of the HIV positive children had cognitive performance at below average to intellectually defective range. Conclusion: School-aged HIV positive children had significantly lower cognitive scores compared with age and gender-matched HIV negative children. Routine neuropsychological evaluation of all school-aged HIV-infected children is recommended. Early detection of cognitive impairment will help in planning appropriate interventions.展开更多
Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on healt...Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on health outcomes and underscores the necessity for comprehensive strategies to address them. Background: Overweight and obesity have been observed in patients with human immunodeficiency virus (HIV) both before and after the initiation of antiretroviral therapy. This study investigates the risk factors associated with overweight and obesity in HIV-infected patients. Methods: A total of 492 HIV-infected patients, both treatment-naïve and those undergoing treatment, were recruited from Yaoundé Central Hospital in Cameroon. Demographic, anthropometric, and biochemical data were collected from each patient. Blood pressure and abdominal fat measurements were also taken. Metabolic syndrome was defined according to IDF criteria. Patients were categorized into two weight status groups: underweight/normal weight and overweight/obese. Results: The prevalence of overweight and obesity was found to be 27.5% and 8.5%, respectively, with only 6.1% of patients being underweight. Abdominal obesity, systolic/diastolic blood pressure, metabolic syndrome, and CD4 cell counts were associated with risk factors in overweight and obese patients. These parameters should be considered when investigating metabolic disorders in HIV-infected patients, as in the general population. Conclusion: Our study indicates a high risk of developing metabolic syndrome among overweight/obese individuals, who were 5.7 times more likely to have metabolic syndrome compared to those of normal weight/underweight. These findings support the hypothesis that overweight and obesity are also prevalent in HIV-infected patients and they are risk factors that have to be taken into consideration to better manage this issue. These results may provide essential information on the fact that being underweight is not the only issue to take into consideration in these patients but that overweight/obesity is now present. Prevention and management strategies should consider both aspects.展开更多
Objective The rising prevalence of childhood obesity is closely associated with suboptimal dietary patterns.To address this public health concern,we conducted a comprehensive study to examine the association between c...Objective The rising prevalence of childhood obesity is closely associated with suboptimal dietary patterns.To address this public health concern,we conducted a comprehensive study to examine the association between coarse cereals consumption and body fat percentage(BFP)in Chinese children and adolescents.Methods The study included 48,305 children aged 6–17 years from 28 districts/counties in 14 provinces across seven regions of China(24,152 girls and 24,153 boys).BFP was examined using bioelectrical impedance analysis in the early morning.Coarse cereals consumption was assessed using a Food Frequency Questionnaire and categorized into three groups:0 g/1,000 kcal per day,0–10 g/1,000kcal per day,and>10 g/1,000 kcal per day(daily consumption of coarse cereals×1,000/total energy consumption).Quantile regression model was used to analyze the association between coarse cereals and BFP,adjusting for potential confounders such as age,pubertal development stage,urban/rural and regional factors,total daily dietary energy consumption,sedentary time,moderate-to-high physical activity,household income,parental education,and consumption of other foods.Results Boys aged 6–10,11–14,and 15–17 years had median daily coarse cereals consumptions of6.6 g,7.1 g,and 5.7 g,with BFP of 19.6%,19.5%,and 17.5%(all P<0.05).Girls in the same age groups showed consumption of 7.1 g,8.4 g,and 6.7 g,with BFP of 20.3%,26.4%,and 31.0%(all P<0.05).The quantile regression results for boys showed that daily consumption of coarse cereals was significantly correlated with their BFP in the 0.15,0.25,and 0.50 quartiles,with regression coefficients of-0.257,-0.221,and-0.330,respectively,after adjusting for potential confounders(P<0.05).For girls,there was a significant correlation with PBF at the 0.05,0.15,0.25,0.50,0.75,and 0.85 quartiles,with regression coefficients of-0.258,-0.366,-0.372,-0.431,-0.472,and-0.503(P<0.05 for all).Conclusions Coarse cereals consumption among Chinese children and adolescents remains relatively low.Higher consumption was inversely associated with BFP in children aged 6–17 years.Future interventional studies should assess how increased coarse cereals consumption prevents childhood obesity.展开更多
This paper systematically reviews epidemiological empirical studies on the association between children’s sleep problems (such as insufficient sleep, sleep-disordered breathing, and circadian rhythm disorders) and co...This paper systematically reviews epidemiological empirical studies on the association between children’s sleep problems (such as insufficient sleep, sleep-disordered breathing, and circadian rhythm disorders) and common oral diseases (dental caries, malocclusion, periodontal diseases, etc.). Starting from potential biological mechanisms, it deeply analyzes the correlation from dimensions including salivary secretion rhythm disturbance, oral microbiota imbalance, abnormal inflammatory response, and abnormal circadian rhythm gene regulation. The limitations of existing research and future development directions are discussed, providing references for clinical interventions and subsequent studies on children’s sleep and oral health.展开更多
Background:This study aims to analyze the genotypes and antibiotic resistance characteristics of Clostridioides difficile(C.difficile)isolated from children under 5 years old with diarrhea in Yunnan Province.Methods:F...Background:This study aims to analyze the genotypes and antibiotic resistance characteristics of Clostridioides difficile(C.difficile)isolated from children under 5 years old with diarrhea in Yunnan Province.Methods:Fecal samples from children under 5 years of age with diarrhea in Kunming city from 2013-2019 were collected for anaerobic culture,isolation,and identification of C.difficile.The antibiotic susceptibility tests and molecular typing of isolated strains were also performed.Results:44 strains of C.difficile were isolated from 896 fecal samples.Of these,40 strains(90.9%)were positive for both tcdA and tcdB,while 4 strains(9.1%)were negative for both.All isolates were negative for cdtA and cdtB.The isolates were classified into 13 STs,the predominant types were ST3(13 strains,29.5%),ST35(8 strains,18.2%),and ST54(5 strains,11.4%).All the strains were susceptible to metronidazole,amoxicillin/clavulanic acid,vancomycin,and amoxicillin.The highest resistance rate was observed against gentamicin(86.36%),followed by polymyxin E(84.09%),quinupristin-dalfopristin(61.36%),and ceftazidime(36.36%).Some patients with diarrhea had C.difficile co-infections with other pathogens,including norovirus,adenovirus,rotavirus or Salmonella or Escherichia coli.Conclusion:C.difficile strains isolated from children under 5 years of age are mostly toxigenic,and the MLST results are highly diverse.Monitoring and prevention of C.difficile should be strengthened.展开更多
BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental...BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.展开更多
This study evaluated the physical development levels of preschool children across different districts of Chongqing,considering variations in age and gender,with the aim of proposing a differentiated physical education...This study evaluated the physical development levels of preschool children across different districts of Chongqing,considering variations in age and gender,with the aim of proposing a differentiated physical education curriculum implementation plan tailored to the differences in age,gender,and physical fitness levels among this population.A total of 1209 preschool children(46.89%girls)aged 3-6 years were tested on eight items:height,weight,standing long jump,10 m toss,seated forward bend,tennis ball toss,continuous jump on both feet and walking the balance beam.One-way variance,multiple comparisons and t-tests were used to calculate and express differences in their results.Overall,preschoolers(City)performed better than preschoolers(Country)in height and standing long jump,and preschoolers(Country)performed better than preschoolers(City)in continuous jumping on both feet.With the exception of the seated forward bend test,there were significant differences in the fitness levels of preschoolers by grade,with preschoolers of different genders(Boys)performing better than preschoolers(Girls)in height,weight,standing long jump and tennis throw.Preschoolers(Girls)performed better than preschoolers(Boys)in the 10 m toss and bend in a sitting position,and the gender differences were more pronounced with increasing age.展开更多
Prenatal maternal psychological distress,particularly depression,has been increasingly recognized as a factor that influences fetal growth;however,its impact on early childhood development remains less well understood...Prenatal maternal psychological distress,particularly depression,has been increasingly recognized as a factor that influences fetal growth;however,its impact on early childhood development remains less well understood.The present study investigated the association between prenatal depression and children's growth trajectories,as well as the odds of overweight and obesity from 1 to 36 months,while also accounting for maternal anxiety and stress.We analyzed data from 4710 mother-child dyads in the Jiangsu Birth Cohort,assessing maternal psychological distress across trimesters and categorizing participants into groups with mild,moderate,and severe depressive symptomatology.Children's weight-for-length z-scores(WLZ)were used to assess overweight/obesity prevalence,and growth patterns were identified through trajectory models.The results from the generalized estimating equations analysis showed that greater depressive symptomatology during pregnancy was associated with a 28%to 41%increase in the odds of childhood overweight/obesity across all three trimesters,compared with mild depressive symptomatology.We identified five distinct WLZ growth trajectory patterns,and found that mothers with greater depressive symptomatology were 39%–47%more likely to have children who followed a very-high-stable growth trajectory,compared with mothers with mild depressive symptomatology.These findings highlight the significant impact of prenatal depression on adverse growth patterns and childhood overweight/obesity,underscoring the need for early intervention.展开更多
Background:The mobility of people in rural areas may lead to more and more left-behind children(LBC)appearing,and being an LBC brings a lot of risks to mental health,which could greatly hinder children’s development ...Background:The mobility of people in rural areas may lead to more and more left-behind children(LBC)appearing,and being an LBC brings a lot of risks to mental health,which could greatly hinder children’s development and undermine their happiness and safety in life.Previous scholars have conducted plenty of studies that focused on Chinese rural LBCs’mental health issues,such as what they exactly look like and some potential factors,but there remains a paucity of reviews about the relationship among certain mental health issues.We will try to figure out how the most common mental health issues of LBC in China’s rural areas correlate with each other,as well as their related factors.Methods:In this study,we used a systematic review approach to analyze 35 publications from Web of Science and EBSCO(to August 2025),followed by the sorting standards of Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020.Results:By mainly using quantitative techniques,we found that Chinese rural LBC are more likely to have mental health issues than children who have no experience of being left behind,and they often suffer from depression,social anxiety,internet addiction,and suicidal ideation.These four mental health issues share influencing factors and positively correlate with each other.We also found that Chinese rural LBCs are somewhat resilient towards the risk factors of mental health issues,and national or social policies and interventions can really help them a lot.Conclusion:For Chinese rural LBC,there are important relationships among the common psychological disorders they often suffer,along with multiple factors that affect their mental health,which can help related scholars and practitioners pay attention to such mechanisms and think more comprehensively when they try to help the children who are left behind.展开更多
AIM:To evaluate the efficacy and safety of 3%diquafosol sodium eye drops in children wearing orthokeratology lenses and with dry eye disease(DED)or at risk of DED.METHODS:Randomized controlled trials.Children with DED...AIM:To evaluate the efficacy and safety of 3%diquafosol sodium eye drops in children wearing orthokeratology lenses and with dry eye disease(DED)or at risk of DED.METHODS:Randomized controlled trials.Children with DED or at risk of DED were randomly assigned in a 1∶1 ratio to receive either 3%diquafosol sodium eye drops 6 times daily or a blank control at Chongqing Aier Children’s Eye Hospital from November 2023 to November 2024.The primary endpoint was the change in the Dry Eye Questionnaire-5(DEQ-5)score from baseline at 12 wk.Secondary assessments included non-invasive breakup time(NIBUT),tear meniscus height,Schirmer’s test,corneal fluorescein staining score,and axial length.RESULTS:A total of 80 participants(80 eyes)were enrolled(40 in each group),the average age of the participants was 11.11±1.88 years,with 43 females(54%)and 37 males(46%),and all completed the trial.After 12 wk,the DEQ-5 scores for the diquafosol sodium group and the blank control group were 1.88±2.02 and 2.88±2.79,respectively(P=0.079).The diquafosol sodium group demonstrated a significant improvement in DEQ-5 dryness symptom scores(-0.33±0.66 vs.0.05±0.81,P=0.023)and NIBUT(6.18±3.73 vs.-1.09±4.40 s,P<0.001)at 12 wk.Additionally,the diquafosol sodium group showed no axial length elongation,in contrast to the blank control group,which exhibited elongation(0.00±0.08 vs.0.05±0.10 mm,P=0.013).No other significant differences were found in the secondary endpoints.No adverse events occurred during the trial.CONCLUSION:Although no statistically significant improvements were noted in the overall DEQ-5 scores,the 3%diquafosol sodium eye drops significantly improved dryness symptoms and NIBUT when compared to the blank control group.展开更多
Objective This study aimed to describe 24-hour movement behaviors,including physical activity,sedentary behavior,and sleep period,among Chinese preschoolers using nationally representative data,and examine disparities...Objective This study aimed to describe 24-hour movement behaviors,including physical activity,sedentary behavior,and sleep period,among Chinese preschoolers using nationally representative data,and examine disparities by age,gender,and residence.Methods A cross-sectional analysis was conducted using data from the China National Nutrition and Health Systematic Survey for Children(2019–2021),including 10,935 children aged 3–5 years.Daily total time of physical activity(TPA),total time of sedentary behaviors(TSB),and total sleep period(TSP)was collected via validated structured questionnaires.Physical inactivity was defined as<180 minutes of TPA per day.Results Median TPA was 121.4(IQR:71.4−209.6)minutes/day,and TSB was 231.4(IQR:175.0−304.3)minutes/day,with 11.46±1.00 hours/day average TSP.Overall,68.8%were physically inactive,with higher prevalence in rural(73.3%)versus urban areas(64.8%,P<0.001).TPA and TSB increased with age,while TSP decreased(all P<0.001).No significant gender differences were observed.Conclusion Most Chinese preschoolers exhibit insufficient physical activity and excessive sedentary behaviors,with notable urban–rural disparities and an escalating trend of ageing.Continuous monitoring and targeted interventions,especially in rural areas,are urgently needed.展开更多
Background:Depression is a growing public health concern among Chinese children and adolescents,with substantial healthcare costs.Physical activity(PA)and organized sport are modifiable behaviours protective against d...Background:Depression is a growing public health concern among Chinese children and adolescents,with substantial healthcare costs.Physical activity(PA)and organized sport are modifiable behaviours protective against depression.This study,therefore,estimated the healthcare costs of depression attributable to insufficient PA and organized sport participation.Methods:A cost-of-illness approach with population attributable fraction(PAF)was applied.Relative risks were derived from longitudinal evidence,prevalence estimates from national Chinese surveys,and depression case numbers from the Global Burden of Disease 2021.Direct healthcare costs were extrapolated from European Union estimates,adjusted to 2024 US dollars(USD),and Chinese expenditure.Sex-stratified analyses were conducted.Results:Estimated depression-related healthcare costs attributable to insufficient PA were approximately 81 million USD,compared with around 84 million USD attributable to insufficient organized sport participation.At the population level,the economic burden attributable to insufficient PA and organized sport was of a similar order of magnitude.Among boys,costs attributable to insufficient organized sport participation(approximately 57 million USD)exceeded those attributable to insufficient PA(around 39 million USD),whereas among girls,costs attributable to insufficient PA(approximately 42 million USD)were higher than those related to organized sport(around 27 million USD).These sex-specific patterns were consistent across sensitivity analyses examining uncertainty in key model parameters.Conclusions:Both insufficient PA and organized sport contribute substantially to depression-related healthcare costs,with sex-specific differences.Policies should prioritise promoting overall PA in girls and organized sport in boys to reduce depression burden and associated expenditures.The magnitude of these attributable costs indicates an economically meaningful burden that is potentially modifiable through behavioural interventions.展开更多
AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional...AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional survey of ocular symptoms and clinical eye examinations were performed in a sample of 35 rural primary schools in the semi-arid region of Kajiado West sub-county in S.W.Kenya,amongst a seminomadic tribe(Maasai).Students in Grades 1-8 were included.Visual acuity was measured using the Snellen“tumbling E”chart at 6 m.Children with symptoms of refractive error underwent non-cycloplegic refraction.RESULTS:A total of 2036 children(1084 males)between the ages of 4-20y were examined.Conjunctival actinic changes were present in 22%(442/2036).Nine cases were seen with a potential squamous carcinoma.No overt classical ocular signs of vitamin A deficiency were noted,although 181(8.9%)children complained of nyctalopia.Three hundred thirty-six(16.5%)children had a visual acuity worse than 6/12 in either eye,were unable to read N10 near text at 40 cm or had symptoms suggestive of refractive error.Refractive data led to an estimate of hyperopia of+1.00 D or more in 3.9%and of myopia of-0.50 D or more in either eye in 3.0%of the study population.CONCLUSION:Solar exposure-and dust-related conjunctival pathology is common.As this may develop into potentially sight-or even life-threatening conditions,it warrants further study,and preventive strategies may be needed.Complaints of nyctalopia were common and could suggest vitamin A deficiency.The prevalence of refractive errors is low in this rural African population.展开更多
Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general ...Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general review was conducted with primary caregivers of children younger than 18 with T1D as the population of interest.Journal searches were performed using the CINAHL,EBSCO,Pub Med,Scopus,Science Direct,and Google Scholar,databases for publications between 2017 and 2024,with full text in English.Results:A total of 26 studies were included in the review.Nine of these studies focused on various educational interventions,both technology-based and non-technology-based.By contrast,17 studies examined the impact of these interventions on caregiver outcomes,such as treatment adherence and glycemic control in children with T1D.So,the following research questions guided this review:(1)What is the effectiveness of diabetes education interventions on glycemic control in children with T1D?(2)How do caregiver knowledge and self-efficacy affect diabetes management outcomes?Conclusions:Diabetes interventions highlight the vital role of empowering caregivers of children with T1D with knowledge,skills,and support to improve and enhance their adherence to treatment,knowledge,and self-efficacy that ultimately contribute to better glycemic control of children as reflected by their Hb A1c levels.This review highlights the importance of diabetes education interventions for caregivers of children with T1D.The evidence indicates that such interventions can improve caregiver knowledge,self-efficacy,and glycemic control in children.However,variability in outcomes suggests that fur ther research is needed to identify the most effective educational strategies.展开更多
Background:Childhood leukemia,a malignant proliferative disorder of the hematopoietic system and the most common childhood cancer,poses a significant threat to the lives and health of affected children.For parents,a l...Background:Childhood leukemia,a malignant proliferative disorder of the hematopoietic system and the most common childhood cancer,poses a significant threat to the lives and health of affected children.For parents,a leukemia diagnosis in their child is a profoundly traumatic event.As primary caregivers,they endure immense psychological distress and caregiving stress throughout the prolonged and demanding treatment process,which can adversely affect their own well-being and caregiving capacity.However,the psychological mechanisms,such as the role of mindfulness,linking caregiver stress to parental coping strategies remain underexplored,and evidence-based interventions to support these parents are needed.Methods:In Study 1,we administered a cross-sectional survey to 242 parents of children with leukemia who were hospitalized at the Affiliated Hospital of Qingdao University between January and August 2024.Participants completed measures assessing caregiver burden,mindful attention awareness,and parental coping style.In Study 2,we further evaluated the effects of a Mindfulness-Based Stress Reduction(MBSR)intervention.Results:The results of Study 1 revealed:(1)The caregiving stress significantly and negatively predicted coping style(β=−1.18,95%CI[−2.18,−0.18],p<0.01).(2)Caregiving stress also significantly and negatively predicted mindfulness(β=−1.90,95%CI[−2.43,−1.38],p<0.01).(3)Conversely,mindfulness significantly and positively predicted coping style(β=0.85,95%CI[0.62,1.07],p<0.01).These findings suggest that mindfulness mediates the relationship between caregiver burden and coping style.In Study 2,the experimental group showed a significant decrease in caregiver stress post-intervention(t=2.24,p<0.05),a significant increase in mindfulness(t=−4.61,p<0.001),and a significant improvement in coping style(t=−2.36,p<0.01).No significant changes were observed in the control group.Conclusion:MBSR can effectively enhance mindfulness and promote adaptive coping strategies,while reducing caregiver burden among parents of children with leukemia.展开更多
文摘Objective: To study the effects of starting antiretroviral treatment (ART) prior the age of two years on the growth (height and weight) of HIV-infected children. Methodology: This was a retrospective cohort study. HIV-infected children on ART aged less than 15 years were divided into two groups Group 1 (G1) comprising children who started ART prior 2 years and Group (G2) those put on treatment thereafter. Main Measures: Percentage of children with growth retardation measured by Height for Age (H/A) and Weight for Age (W/A) Results: In total, we included 90 subjects. The median age was 10 years with a slight female predominance (51.2%). Most children were asymptomatic at the time of the study (96.6%), compliant with treatment (81%), 54.8% of children were on cotrimoxazole, 33% knew their status. At initiation, underweight was predominant in group 1 compared to group 2 (52% versus 29.5%;p = 0.015). Conversely, stunted growth predominated in G2 compared to G1 but without significant difference (38% versus 50%;p = 0.147). At the time of our study (median age of 10 years), catch-up height and weight predominated in G1 compared to G2;only a small proportion remained below −2SD (4% versus 18.2%;p = 0.015 and 9% versus 29.5%;p = 0.006 respectively for underweight and stunted growth). Conclusion and Global Health Implications: Growth retardation was common at ART initiation. Catch-up in height was more evident in the early treatment group. Initiation of ART before the age of 2 years rather influences children’s height than weight. The result of this study further emphasizes the need of early ART and closed clinical monitoring to better assess the impact of ART in areas with high rates of undernutrition.
基金supported by the Faculty of Medicine Siriraj Hospital,Mahidol University,Bangkok,Thailand,[Grant Number(IO)R015832028].Oxford Immunotec and Biomed diagnostics(Thailand)provided the T-SPOT.TB test kit
文摘Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HIV-infected patients aged 5-18 years receiving antiretroviral treatment with CD4 T-lymphocytes>25%or>500 cells/mm3 for at least 6 months.QuantiF ERON-TB Gold,T-SPOT.TB,and tuberculin skin test were performed in each patient.Results:A total of 50 patients were enrolled with median age of 13.7 years,CD4 counts of 753(IQR:587-989)cells/mm3.Among 27 patients with tuberculosis(16)or tuberculosis exposure(11),8(29.6%)were positive to at least one test,2(7.4%)were positive QuantiFERON-TB Gold,3(11.1%)positive T-SPOT.TB,and 7(25.9%)had tuberculin skin test≥5 mm.Among 23 patients without history of tuberculosis or exposure,all had negative interferon gamma release assays,while 2(8.7%)had positive tuberculin skin test.Conclusions:All tests had low sensitivity despite immune reconstitution.
文摘Objectives: Antiretroviral therapy (ART) has been associated with lipodystrophy in children. We evaluated changes in various anthropometric measurements for the assessment of lipodystrophy and assessed whether there was an association with use of protease inhibitors (PI), non-PI containing ART and/or stavudine (d4T). Methods: Eighty-five HIV-infected children attending the HIV clinic at Great Ormond Street Hospital (GOSH) were included. The average follow-up was 8.4 months (range 3 - 12 months). Body fat redistribution was assessed by anthropometric measurements including skinfold thickness and circumferences of upper and lower limbs. Measurements were converted to age- and sex-adjusted z-scores through development stages including puberty. Results: Sixty children had taken ART;37 received PI-containing;38 received d4T;25 had never been treated. In the studied population, clinically important changes with decreases in biceps (BSF), subscapular skinfolds and total body fat (4SFT) over period of 12 months were observed. Some increase was noticed in triceps skinfolds (TSF). Limbs circumferences remained at the same level. Further we looked at 4 months basis changes in anthropometric measurements stratified by baseline ART. Generally z-scores of anthropometric measurements were lower in therapy naive children when compared to ART groups. PI-based ART regimens resulted in significant increases in BSF with a trend towards increases in TSF, suprailiac and 4SFT. Mid-arm and thigh circumferences were higher in PI compared to naive group. Similarly, significant changes in BSF z-scores were associated with d4T use. Increases were seen in TSF and mid-arm circumference and decreases were observed in subscapular skinfolds and calf circumference z-scores. Conclusions: Body fat redistribution in HIV-infected children with sub-clinical lipodystrophy could be detected by anthropometric measurements, particularly when PI or d4T is included in ART. Over time, changes with increase in arm and trunk fat, and no change or decrease in leg fat were more pronounced among ART-receiving children.
文摘Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.
文摘Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngeal colonization is a risk factor for pneumococcal disease, a leading cause of complications and death in infants. HIV-infected persons are at high risk of invasive pneumococcal disease. Method: Nasopharyngeal swabs were collected from 296 HIV infected children below five years recruited from Gertrude’s Children hospital and Nazareth Hospital Nairobi, Kenya. The nasopharyngeal swabs were processed to isolate S. pneumoniae, which were serotyped and tested for drug susceptibility. Results: The carriage prevalence of S. pneumoniae in the study was 30.4% while the isolated serotypes were (in order of decreasing frequency): 35B, 19F, 3, 13, 15A, 11A, 16F, 7C and 23A. Most of the serotypes were resistant to the commonly used antibiotics but all were susceptible to vancomycin and chloramphenicol. Conclusion: Carriage prevalence of nasopharyngeal S. pneumonia in HIV infected children was lower than that of similar prevalence studies in children. Most of the S. pneumoniae isolates were however non pneumococcal vaccine isolates.
文摘Objective: Studies available on cognitive function among school-aged HIV-infected African and in particular Nigerian children are few. The purpose of the study was to assess the neurocognitive function of a group of HIV-infected schoolaged (6 - 15 years) children using the Raven’s Standard Progressive Matrices (RPM). Method: Cognitive assessments of 69 HIV positive children and 69 age- and sex-matched apparently healthy HIV negative control children were performed using the Raven’s Standard Progressive Matrices (RPM). The children were subdivided (Piaget’s developmental staging) into two sub-groups: the concrete operation stage (6 - 11 years) and the formal operation stage (12 - 15 years) for analysis. Result: The mean RPM score for the HIV positive children was 18.2 (8.0 - 47.0, SD 9.8) which was significantly lower than the score of 27.2 (8.0 - 52.0, SD 13.8) for the HIV negative children (p < 0.001). On the RPM grading and using the HIV negative children as the standard, 56.5% of the HIV positive children had cognitive performance at below average to intellectually defective range. Conclusion: School-aged HIV positive children had significantly lower cognitive scores compared with age and gender-matched HIV negative children. Routine neuropsychological evaluation of all school-aged HIV-infected children is recommended. Early detection of cognitive impairment will help in planning appropriate interventions.
文摘Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on health outcomes and underscores the necessity for comprehensive strategies to address them. Background: Overweight and obesity have been observed in patients with human immunodeficiency virus (HIV) both before and after the initiation of antiretroviral therapy. This study investigates the risk factors associated with overweight and obesity in HIV-infected patients. Methods: A total of 492 HIV-infected patients, both treatment-naïve and those undergoing treatment, were recruited from Yaoundé Central Hospital in Cameroon. Demographic, anthropometric, and biochemical data were collected from each patient. Blood pressure and abdominal fat measurements were also taken. Metabolic syndrome was defined according to IDF criteria. Patients were categorized into two weight status groups: underweight/normal weight and overweight/obese. Results: The prevalence of overweight and obesity was found to be 27.5% and 8.5%, respectively, with only 6.1% of patients being underweight. Abdominal obesity, systolic/diastolic blood pressure, metabolic syndrome, and CD4 cell counts were associated with risk factors in overweight and obese patients. These parameters should be considered when investigating metabolic disorders in HIV-infected patients, as in the general population. Conclusion: Our study indicates a high risk of developing metabolic syndrome among overweight/obese individuals, who were 5.7 times more likely to have metabolic syndrome compared to those of normal weight/underweight. These findings support the hypothesis that overweight and obesity are also prevalent in HIV-infected patients and they are risk factors that have to be taken into consideration to better manage this issue. These results may provide essential information on the fact that being underweight is not the only issue to take into consideration in these patients but that overweight/obesity is now present. Prevention and management strategies should consider both aspects.
基金supported by the Special Project of National Science and Technology Basic Resources Survey(Grant No.2017FY101100)。
文摘Objective The rising prevalence of childhood obesity is closely associated with suboptimal dietary patterns.To address this public health concern,we conducted a comprehensive study to examine the association between coarse cereals consumption and body fat percentage(BFP)in Chinese children and adolescents.Methods The study included 48,305 children aged 6–17 years from 28 districts/counties in 14 provinces across seven regions of China(24,152 girls and 24,153 boys).BFP was examined using bioelectrical impedance analysis in the early morning.Coarse cereals consumption was assessed using a Food Frequency Questionnaire and categorized into three groups:0 g/1,000 kcal per day,0–10 g/1,000kcal per day,and>10 g/1,000 kcal per day(daily consumption of coarse cereals×1,000/total energy consumption).Quantile regression model was used to analyze the association between coarse cereals and BFP,adjusting for potential confounders such as age,pubertal development stage,urban/rural and regional factors,total daily dietary energy consumption,sedentary time,moderate-to-high physical activity,household income,parental education,and consumption of other foods.Results Boys aged 6–10,11–14,and 15–17 years had median daily coarse cereals consumptions of6.6 g,7.1 g,and 5.7 g,with BFP of 19.6%,19.5%,and 17.5%(all P<0.05).Girls in the same age groups showed consumption of 7.1 g,8.4 g,and 6.7 g,with BFP of 20.3%,26.4%,and 31.0%(all P<0.05).The quantile regression results for boys showed that daily consumption of coarse cereals was significantly correlated with their BFP in the 0.15,0.25,and 0.50 quartiles,with regression coefficients of-0.257,-0.221,and-0.330,respectively,after adjusting for potential confounders(P<0.05).For girls,there was a significant correlation with PBF at the 0.05,0.15,0.25,0.50,0.75,and 0.85 quartiles,with regression coefficients of-0.258,-0.366,-0.372,-0.431,-0.472,and-0.503(P<0.05 for all).Conclusions Coarse cereals consumption among Chinese children and adolescents remains relatively low.Higher consumption was inversely associated with BFP in children aged 6–17 years.Future interventional studies should assess how increased coarse cereals consumption prevents childhood obesity.
文摘This paper systematically reviews epidemiological empirical studies on the association between children’s sleep problems (such as insufficient sleep, sleep-disordered breathing, and circadian rhythm disorders) and common oral diseases (dental caries, malocclusion, periodontal diseases, etc.). Starting from potential biological mechanisms, it deeply analyzes the correlation from dimensions including salivary secretion rhythm disturbance, oral microbiota imbalance, abnormal inflammatory response, and abnormal circadian rhythm gene regulation. The limitations of existing research and future development directions are discussed, providing references for clinical interventions and subsequent studies on children’s sleep and oral health.
基金supported by Yunnan Provincial Key Research and Development Program(grant No.202503AP140034)Infectious Disease Spectrum and Epidemiology Project of YNCDC(grant No.YNAPM2025-003).
文摘Background:This study aims to analyze the genotypes and antibiotic resistance characteristics of Clostridioides difficile(C.difficile)isolated from children under 5 years old with diarrhea in Yunnan Province.Methods:Fecal samples from children under 5 years of age with diarrhea in Kunming city from 2013-2019 were collected for anaerobic culture,isolation,and identification of C.difficile.The antibiotic susceptibility tests and molecular typing of isolated strains were also performed.Results:44 strains of C.difficile were isolated from 896 fecal samples.Of these,40 strains(90.9%)were positive for both tcdA and tcdB,while 4 strains(9.1%)were negative for both.All isolates were negative for cdtA and cdtB.The isolates were classified into 13 STs,the predominant types were ST3(13 strains,29.5%),ST35(8 strains,18.2%),and ST54(5 strains,11.4%).All the strains were susceptible to metronidazole,amoxicillin/clavulanic acid,vancomycin,and amoxicillin.The highest resistance rate was observed against gentamicin(86.36%),followed by polymyxin E(84.09%),quinupristin-dalfopristin(61.36%),and ceftazidime(36.36%).Some patients with diarrhea had C.difficile co-infections with other pathogens,including norovirus,adenovirus,rotavirus or Salmonella or Escherichia coli.Conclusion:C.difficile strains isolated from children under 5 years of age are mostly toxigenic,and the MLST results are highly diverse.Monitoring and prevention of C.difficile should be strengthened.
文摘BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.
基金2024 Chongqing Vocational Education Teaching Reform Research Project(Project No.:Z2241594)2025 Project of The Science and Technology Research Program of the Chongqing Education Commission in China(Project No.:KJZD-K202502902)。
文摘This study evaluated the physical development levels of preschool children across different districts of Chongqing,considering variations in age and gender,with the aim of proposing a differentiated physical education curriculum implementation plan tailored to the differences in age,gender,and physical fitness levels among this population.A total of 1209 preschool children(46.89%girls)aged 3-6 years were tested on eight items:height,weight,standing long jump,10 m toss,seated forward bend,tennis ball toss,continuous jump on both feet and walking the balance beam.One-way variance,multiple comparisons and t-tests were used to calculate and express differences in their results.Overall,preschoolers(City)performed better than preschoolers(Country)in height and standing long jump,and preschoolers(Country)performed better than preschoolers(City)in continuous jumping on both feet.With the exception of the seated forward bend test,there were significant differences in the fitness levels of preschoolers by grade,with preschoolers of different genders(Boys)performing better than preschoolers(Girls)in height,weight,standing long jump and tennis throw.Preschoolers(Girls)performed better than preschoolers(Boys)in the 10 m toss and bend in a sitting position,and the gender differences were more pronounced with increasing age.
基金supported by the National Natural Science Foundation of China(Grant No.82373581 to Yuan Lin).
文摘Prenatal maternal psychological distress,particularly depression,has been increasingly recognized as a factor that influences fetal growth;however,its impact on early childhood development remains less well understood.The present study investigated the association between prenatal depression and children's growth trajectories,as well as the odds of overweight and obesity from 1 to 36 months,while also accounting for maternal anxiety and stress.We analyzed data from 4710 mother-child dyads in the Jiangsu Birth Cohort,assessing maternal psychological distress across trimesters and categorizing participants into groups with mild,moderate,and severe depressive symptomatology.Children's weight-for-length z-scores(WLZ)were used to assess overweight/obesity prevalence,and growth patterns were identified through trajectory models.The results from the generalized estimating equations analysis showed that greater depressive symptomatology during pregnancy was associated with a 28%to 41%increase in the odds of childhood overweight/obesity across all three trimesters,compared with mild depressive symptomatology.We identified five distinct WLZ growth trajectory patterns,and found that mothers with greater depressive symptomatology were 39%–47%more likely to have children who followed a very-high-stable growth trajectory,compared with mothers with mild depressive symptomatology.These findings highlight the significant impact of prenatal depression on adverse growth patterns and childhood overweight/obesity,underscoring the need for early intervention.
基金funded by the Fundamental Research Funds for the Central Universities(No.1233300002).
文摘Background:The mobility of people in rural areas may lead to more and more left-behind children(LBC)appearing,and being an LBC brings a lot of risks to mental health,which could greatly hinder children’s development and undermine their happiness and safety in life.Previous scholars have conducted plenty of studies that focused on Chinese rural LBCs’mental health issues,such as what they exactly look like and some potential factors,but there remains a paucity of reviews about the relationship among certain mental health issues.We will try to figure out how the most common mental health issues of LBC in China’s rural areas correlate with each other,as well as their related factors.Methods:In this study,we used a systematic review approach to analyze 35 publications from Web of Science and EBSCO(to August 2025),followed by the sorting standards of Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020.Results:By mainly using quantitative techniques,we found that Chinese rural LBC are more likely to have mental health issues than children who have no experience of being left behind,and they often suffer from depression,social anxiety,internet addiction,and suicidal ideation.These four mental health issues share influencing factors and positively correlate with each other.We also found that Chinese rural LBCs are somewhat resilient towards the risk factors of mental health issues,and national or social policies and interventions can really help them a lot.Conclusion:For Chinese rural LBC,there are important relationships among the common psychological disorders they often suffer,along with multiple factors that affect their mental health,which can help related scholars and practitioners pay attention to such mechanisms and think more comprehensively when they try to help the children who are left behind.
文摘AIM:To evaluate the efficacy and safety of 3%diquafosol sodium eye drops in children wearing orthokeratology lenses and with dry eye disease(DED)or at risk of DED.METHODS:Randomized controlled trials.Children with DED or at risk of DED were randomly assigned in a 1∶1 ratio to receive either 3%diquafosol sodium eye drops 6 times daily or a blank control at Chongqing Aier Children’s Eye Hospital from November 2023 to November 2024.The primary endpoint was the change in the Dry Eye Questionnaire-5(DEQ-5)score from baseline at 12 wk.Secondary assessments included non-invasive breakup time(NIBUT),tear meniscus height,Schirmer’s test,corneal fluorescein staining score,and axial length.RESULTS:A total of 80 participants(80 eyes)were enrolled(40 in each group),the average age of the participants was 11.11±1.88 years,with 43 females(54%)and 37 males(46%),and all completed the trial.After 12 wk,the DEQ-5 scores for the diquafosol sodium group and the blank control group were 1.88±2.02 and 2.88±2.79,respectively(P=0.079).The diquafosol sodium group demonstrated a significant improvement in DEQ-5 dryness symptom scores(-0.33±0.66 vs.0.05±0.81,P=0.023)and NIBUT(6.18±3.73 vs.-1.09±4.40 s,P<0.001)at 12 wk.Additionally,the diquafosol sodium group showed no axial length elongation,in contrast to the blank control group,which exhibited elongation(0.00±0.08 vs.0.05±0.10 mm,P=0.013).No other significant differences were found in the secondary endpoints.No adverse events occurred during the trial.CONCLUSION:Although no statistically significant improvements were noted in the overall DEQ-5 scores,the 3%diquafosol sodium eye drops significantly improved dryness symptoms and NIBUT when compared to the blank control group.
基金supported by National Special Program for Science&Technology Basic Resources Investigation of China(Grant No.2017GFY101100).
文摘Objective This study aimed to describe 24-hour movement behaviors,including physical activity,sedentary behavior,and sleep period,among Chinese preschoolers using nationally representative data,and examine disparities by age,gender,and residence.Methods A cross-sectional analysis was conducted using data from the China National Nutrition and Health Systematic Survey for Children(2019–2021),including 10,935 children aged 3–5 years.Daily total time of physical activity(TPA),total time of sedentary behaviors(TSB),and total sleep period(TSP)was collected via validated structured questionnaires.Physical inactivity was defined as<180 minutes of TPA per day.Results Median TPA was 121.4(IQR:71.4−209.6)minutes/day,and TSB was 231.4(IQR:175.0−304.3)minutes/day,with 11.46±1.00 hours/day average TSP.Overall,68.8%were physically inactive,with higher prevalence in rural(73.3%)versus urban areas(64.8%,P<0.001).TPA and TSB increased with age,while TSP decreased(all P<0.001).No significant gender differences were observed.Conclusion Most Chinese preschoolers exhibit insufficient physical activity and excessive sedentary behaviors,with notable urban–rural disparities and an escalating trend of ageing.Continuous monitoring and targeted interventions,especially in rural areas,are urgently needed.
文摘Background:Depression is a growing public health concern among Chinese children and adolescents,with substantial healthcare costs.Physical activity(PA)and organized sport are modifiable behaviours protective against depression.This study,therefore,estimated the healthcare costs of depression attributable to insufficient PA and organized sport participation.Methods:A cost-of-illness approach with population attributable fraction(PAF)was applied.Relative risks were derived from longitudinal evidence,prevalence estimates from national Chinese surveys,and depression case numbers from the Global Burden of Disease 2021.Direct healthcare costs were extrapolated from European Union estimates,adjusted to 2024 US dollars(USD),and Chinese expenditure.Sex-stratified analyses were conducted.Results:Estimated depression-related healthcare costs attributable to insufficient PA were approximately 81 million USD,compared with around 84 million USD attributable to insufficient organized sport participation.At the population level,the economic burden attributable to insufficient PA and organized sport was of a similar order of magnitude.Among boys,costs attributable to insufficient organized sport participation(approximately 57 million USD)exceeded those attributable to insufficient PA(around 39 million USD),whereas among girls,costs attributable to insufficient PA(approximately 42 million USD)were higher than those related to organized sport(around 27 million USD).These sex-specific patterns were consistent across sensitivity analyses examining uncertainty in key model parameters.Conclusions:Both insufficient PA and organized sport contribute substantially to depression-related healthcare costs,with sex-specific differences.Policies should prioritise promoting overall PA in girls and organized sport in boys to reduce depression burden and associated expenditures.The magnitude of these attributable costs indicates an economically meaningful burden that is potentially modifiable through behavioural interventions.
基金Supported by Vision International Eye Missions-USA,“One Drop for All”,Italy,and Private Donors in the Netherlands.
文摘AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional survey of ocular symptoms and clinical eye examinations were performed in a sample of 35 rural primary schools in the semi-arid region of Kajiado West sub-county in S.W.Kenya,amongst a seminomadic tribe(Maasai).Students in Grades 1-8 were included.Visual acuity was measured using the Snellen“tumbling E”chart at 6 m.Children with symptoms of refractive error underwent non-cycloplegic refraction.RESULTS:A total of 2036 children(1084 males)between the ages of 4-20y were examined.Conjunctival actinic changes were present in 22%(442/2036).Nine cases were seen with a potential squamous carcinoma.No overt classical ocular signs of vitamin A deficiency were noted,although 181(8.9%)children complained of nyctalopia.Three hundred thirty-six(16.5%)children had a visual acuity worse than 6/12 in either eye,were unable to read N10 near text at 40 cm or had symptoms suggestive of refractive error.Refractive data led to an estimate of hyperopia of+1.00 D or more in 3.9%and of myopia of-0.50 D or more in either eye in 3.0%of the study population.CONCLUSION:Solar exposure-and dust-related conjunctival pathology is common.As this may develop into potentially sight-or even life-threatening conditions,it warrants further study,and preventive strategies may be needed.Complaints of nyctalopia were common and could suggest vitamin A deficiency.The prevalence of refractive errors is low in this rural African population.
文摘Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general review was conducted with primary caregivers of children younger than 18 with T1D as the population of interest.Journal searches were performed using the CINAHL,EBSCO,Pub Med,Scopus,Science Direct,and Google Scholar,databases for publications between 2017 and 2024,with full text in English.Results:A total of 26 studies were included in the review.Nine of these studies focused on various educational interventions,both technology-based and non-technology-based.By contrast,17 studies examined the impact of these interventions on caregiver outcomes,such as treatment adherence and glycemic control in children with T1D.So,the following research questions guided this review:(1)What is the effectiveness of diabetes education interventions on glycemic control in children with T1D?(2)How do caregiver knowledge and self-efficacy affect diabetes management outcomes?Conclusions:Diabetes interventions highlight the vital role of empowering caregivers of children with T1D with knowledge,skills,and support to improve and enhance their adherence to treatment,knowledge,and self-efficacy that ultimately contribute to better glycemic control of children as reflected by their Hb A1c levels.This review highlights the importance of diabetes education interventions for caregivers of children with T1D.The evidence indicates that such interventions can improve caregiver knowledge,self-efficacy,and glycemic control in children.However,variability in outcomes suggests that fur ther research is needed to identify the most effective educational strategies.
基金approved by the Ethics Review Committee of Northwest Normal University(Approval No.:[2023028]).All participants signed the informed consent in this study.
文摘Background:Childhood leukemia,a malignant proliferative disorder of the hematopoietic system and the most common childhood cancer,poses a significant threat to the lives and health of affected children.For parents,a leukemia diagnosis in their child is a profoundly traumatic event.As primary caregivers,they endure immense psychological distress and caregiving stress throughout the prolonged and demanding treatment process,which can adversely affect their own well-being and caregiving capacity.However,the psychological mechanisms,such as the role of mindfulness,linking caregiver stress to parental coping strategies remain underexplored,and evidence-based interventions to support these parents are needed.Methods:In Study 1,we administered a cross-sectional survey to 242 parents of children with leukemia who were hospitalized at the Affiliated Hospital of Qingdao University between January and August 2024.Participants completed measures assessing caregiver burden,mindful attention awareness,and parental coping style.In Study 2,we further evaluated the effects of a Mindfulness-Based Stress Reduction(MBSR)intervention.Results:The results of Study 1 revealed:(1)The caregiving stress significantly and negatively predicted coping style(β=−1.18,95%CI[−2.18,−0.18],p<0.01).(2)Caregiving stress also significantly and negatively predicted mindfulness(β=−1.90,95%CI[−2.43,−1.38],p<0.01).(3)Conversely,mindfulness significantly and positively predicted coping style(β=0.85,95%CI[0.62,1.07],p<0.01).These findings suggest that mindfulness mediates the relationship between caregiver burden and coping style.In Study 2,the experimental group showed a significant decrease in caregiver stress post-intervention(t=2.24,p<0.05),a significant increase in mindfulness(t=−4.61,p<0.001),and a significant improvement in coping style(t=−2.36,p<0.01).No significant changes were observed in the control group.Conclusion:MBSR can effectively enhance mindfulness and promote adaptive coping strategies,while reducing caregiver burden among parents of children with leukemia.
